Study review: Depressed physicians more likely to commit medical errors
Monday, December 09, 2019
A physician who is depressed is more likely to commit medical errors: This is the primary finding from a review of studies — 11 prior studies that included more than 21,000 physicians —published in JAMA Network Open.
Per the findings, physicians with a positive screening for depression were very likely to report medical errors. Further examination found that the association between depressive symptoms in physicians and medical errors is bidirectional.
The studies suggest that, in the United States, as many as 98,000 to 251,000 hospitalized patients die each year because a preventable adverse event. Medical errors are considered a significant source of morbidity and account for billions of dollars in financial losses to healthcare systems every year.
Additionally, studies of physicians point to the potential individual and work environments as possible sources of interventions to prevent the development of depressive symptoms among these professionals. “Research on the efficacy of interventions to reduce depressive symptoms in physicians has shown positive results,” the report’s authors said.
“Given that depression is preventable and treatable, a reliable estimate of the degree to which physicians with a positive screening for depression are at higher risk for medical errors would be useful,” the review authors noted. “Such an estimate would inform public health decision-making on strategies to improve patient safety and physician well-being.”
Nine studies (82%) took place in the United States, one (9%) in Japan, and one (9%) in South Korea. Eight studies (73%) included only training physicians (interns and residents), and three (27%) recruited physicians from any career level. Seven studies recruited physicians from multiple specialties, whereas four recruited physicians from a single specialty. Among these four studies, one focused on pediatric residents, one on anesthesiology residents, and two on internal medicine residents.
All the studies involved self-reported medical errors and were not necessarily verifiable.
Based on the results, the study's authors urged healthcare institutions to remove barriers that may keep doctors suffering from depression from obtaining help.
For physicians, the combination of long hours, often grueling medical procedures and lives on the line, can create an enormous amount of stress. That can take a toll on mental health, and many doctors say they suffer from depression. A Medscape survey from last year indicated 71% of doctors are suffering from some form of burnout, depression, or both.
Up to 400 doctors in the U.S. kill themselves every year, according to a study on that topic. Given that depression can dull mental acuity, that puts clinicians at risk for committing medical errors.
Studies that include physicians from different countries could answer whether cultural and socioeconomic aspects play a role in the associations between depressive symptoms and errors, researchers said. Likewise, there is a need for more research into the degree to which interventions for reducing physician depressive symptoms could mitigate medical errors and improve physician well-being and patient care, they added.
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